The Roof of Africa

This isn’t a really a medicine-related post. It’s about my experience climbing Kilimanjaro, something I did when I was on leave. When I was supposed to be putting work aside. But you know how it goes, you can take the doctor out of Medicine but not the other way around. Everyday something reminded me of my work. Everyday I alternated between thinking I might die and marveling at the wonder that is physiology. Besides that however, the experience itself was definitely something I felt was worthy to be shared. So here’s a day by day of my trip to the highest point in Africa. It might be boring for some. As my brother said “No one wants to read 17 pages of your hike up Kilimanjaro!” So proceed with caution. 

We started off in Arusha, a town about 200km from Londorossi Gate, where our journey would begin. Even from a whole 200km away Kilimanjaro looked majestic and towering, and terrifying. Our guide told us that we were lucky it was a clear day so we could see the summit. I begged to differ. What you can’t see, can’t hurt you, right? All I could do for the entire 200km drive was stare up at the snow-capped peak and marvel (while trying not to cry) at how high it is. Why on earth did I think it would be a good idea to climb this damn mountain? It is so high that it has snow on it when it’s 25 degrees celsius at its base. It is so high that you can only see it’s peak on a clear day. It is so high that you fly almost level with it in an airplane! I don’t know about you but I think that is pretty high. And now I was about to climb this thing! The feelings I felt (there were many) reminded me of how I felt when starting internship. Part of me wanted to turn around and run away. And when I say ‘part’, I mean ‘most’. The rest of me was eager to see just how far I could push myself. Eager for the challenge and the chance to prove myself. Kind of like starting internship, except this time no one would get hurt (hopefully) while I was attempting to prove myself, so slightly less pressure. 

Day One

2150m – 2650m

After registering, and taking the first of many photos with many signs, we started the official part of the trek. The part where you actually have to walk. And let me tell you, those first five steps were even more of a shock than seeing the peak for the first time. You are already at 2150m when you start walking, and my lungs could feel it! I was short of breath five steps in, granted they were steep uphill steps, but still. I went from grade 1 dyspnoea to grade 3 pretty quickly. Now I know what those poor cardiac failure patients feel like everyday. I also realized that, in the future, when somebody asks me if I’m fit, my answer will be “yes… at sea level.” Altitude is a bitch! Things did get a bit better after I realized I wasn’t dying and this was just physiology at its finest. We slept in the rain forest that night at 2650m. 

Day Two

2650m – 3610m

Apart from summit day, day two was the toughest for me. It was a long day and it was hot (no more shady rain forest) and we gained 1000m, so most of it was steady and steep uphill. I think I drank about 3.5 liters of water that day, which reminds me – drinking water is not easy when you are at 3610m above sea level, already pretty short of breath and having to suck it out of the bladder in your back pack! Our guides kept nagging us to drink, and all I could think was “I’m trying to breath, I don’t have time to drink!” The other thought that crossed my mind was that all this water, in combination with the Diamox I was taking to prevent altitude sickness, was going to lead to a lot of urinating, which is a problem when there are no toilets in sight for most of the day. And when there are toilets they are not sanitary in any way or form! Luckily, the company I hiked with provided us with a personal toilet tent at each camp. For the rest of the day, however, it was either hold it in, or “go visit a flower”. All I can say is – to my patient’s on Lasix, I feel your pain! 

Day Three

3610 – 4206m

More climbing today, but much more managable. I felt like my body was adjusting to the altitude. I was still producing abnormally large amounts of urine, but I was getting used to the shortness of breath, and those steep uphill steps were not too difficult anymore. This however meant that you really start to realize just how slowly you are walking – its almost painful. Anyone who has climbed Kili will know what I’m talking about – pole pole. Pole Pole means slowly slowly in Swahili. And they really mean it! It took us about 4 hours to walk 7km – a distance I would normally cover in an hour on a normal day. I’m not complaining though, it really helps your body to adjust to the altitude, and of course it gives you plenty of time to enjoy the scenery. A lot of this day was spent trekking over vast plateau that seems to go on endlessly until it disappears into a sea of clouds. From this point on we were always above the clouds, another reminder of just how high up you actually are. Being above the clouds also means cold. I really started to feel the cold, especially at night. The sleeping bag I hired was a -18 degree C bag but I was still cold. That sleeping bag and I were not friends at all. I had multiple wrestling matches with it and practically strangle myself with its cord in order to keep the cold out and the heat in. Let’s just say, I’m done with sleeping bags for a while. It didn’t help that the two Americans I was with had supernatural cold tolerance and walked around in short sleeves, making me think I was crazy for wearing 16 layers! 

Day Four

4206m – 3900m

I know what you are thinking – going down 300m seems counter productive, but we were acclimatizing. We started trekking around the mountain, toward the eastern side where we would begin the real ascent (I thought day two was uphill – the real deal was still to come). We actually spent three nights around 4000m to acclimatize. Here you could see the summit up close but you knew it was still so far! I also started to feel exceptionally dirty by this point. It was my fourth day without a shower. As we left the moorland behind and reached the alpine desert region, everything is dusty all the time, no matter how hard you try to stay clean. My wet wipes were beginning to look like the alcohol swabs I use to clean patients skin before taking their blood. I always wondered how a person’s skin could be so dirty that it turns a white swab brown – now I know how. Nevermind the state of my hair! Thank goodness it was cold because I could just wear a beanie the whole time and pretend all was well. Even the Americans started bringing out their gloves and snow jackets, and it was about time too. We woke up with frost covering our tents the next morning. 

Day Five

3900m – 3995m

Today we tackled Baranco Wall – and its called that for a reason. It is literally a 300m wall of rock, which we had to climb. It was the only day that all four limbs were needed in the ascent. Half way up, when we had stopped for a water break, I was looking down at our campsite 200m below and our guide decided it was a good idea to tell me the story of how a porter fell from the ledge we were standing on and broke his neck. But I would be fine, he said, pole pole! We were all fine and made it to the top, necks intact. At the top, I actually met two South Africans. They knew I was South African because after they thanked me for taking a photo for them I said “pleasure” instead of “You’re welcome”. It’s amazing how meeting fellow South Africans can suddenly make you feel so at home. I was traveling alone, and while the people I was with were great, I did feel a bit lonely at times, but hearing those South African accents, even the “Ya” that makes us sounds so stupid, was just what I needed. That evening was one of the most beautiful. We camped on a slope looking over another sea of clouds and the sun colored them different shades of pink and orange, and as the sun faded the moon took over and the snow on the mountain glowed in the dark. I remember looking up at the summit and thinking, even if I don’t get to the top, atleast I got to see this! 

Day Six 

Summit Day

3995m – 5895m

After a morning hike to base camp at 4600m, we had lunch and our guide prepped us for our summit. He interrogated us about how many layers of clothes we each planned on wearing – he insisted we wear three pairs of pants, which we initially thought was absurd. He also told us what to expect on the way up and gave us the descent plan should someone experience altitude sickness. He tried to reassure us by telling us that he has a “100% success rate”, but then he added “so don’t let me down” and left us to try and get some rest. I suddenly became acutely aware of the effect of the altitude on my body. Maybe it was the looming summit hike, or maybe it was really the altitude. I don’t know – but I do know that my resting pulse rate was a borderline tachycardia and just climbing out my tent and walking to the toilet had me breathing like I’d just run a half marathon. I realized that I hadn’t really felt like eating at lunch time. Loss of appetite is another known effect of high altitudes. This is quite significant for me, because if you know me, you’ll know that I can eat at any time. Sometimes I just eat for fun, even if I’m not hungry. It was a great relief when, at dinner time, I almost finished a kilogram of rice. “Altitude, you can have my pulse rate and my fitness, but you will never take my appetite!” Jokes aside though, I was super nervous. I knew that altitude sickness claims a few lives every year, and that if I showed any signs they’d send me down. Imagine going all that way and not summiting. Or dying – my friends and family had already claimed my possessions should I not return! 

The summit

We left just after midnight, with the plan to reach Stella Point (5756m) by sunrise and then continue onto Uhuru Peak. That 5km trek in the dark, at -15 degrees, with only 10% oxygen in the air, was the toughest mental challenge I have faced in my life. The physical part of it was not too bad, again we went ‘pole pole’, so you don’t feel the physical strain. But when all you can see is the person’s boots in front of you, or a long line of headlamps ahead when you look up, and you have no idea how far you still have to go, every step is a mental test. At one point I found myself counting my steps, that was the only way my brain would make my feet move. I was also so cold I couldn’t feel my fingers for three hours, despite wearing two pairs of gloves – I kept thinking that I have 6 hours before they fall off. We, being a smaller group, moved faster than the other groups and actually made it to the top before sunrise. We had about 20 minutes to go until sunrise when we took our photos on Uhuru Peak. We contemplated waiting until the sun rose but we were so cold we actually just wanted to keep moving. And one of our group started vomitting and having visual disturbances – altitude sickness at its finest – so we actually didn’t have much of a choice but to go down. On our way back the sun did rise, and it was breathtaking. We paused to watch it creep over the horizon. Immediately you could feel its heat, and my hands defrosted. Thats when I first realized the enormity of the moment. I recently read a book in which the author described the exact experience of watching the sun rise from the top of a mountain: 

“No philosopher can describe the sublime better than this, standing between day and night. It was as if this were the moment God said, ‘Let there be light!’ You could not help but feel your speck-like existence against the immensity of the mountain, and yet still feel your own two feet on the talus, reaffirming your presence amid the grandeur.” – Paul Kalanithi

I immediately thought of that moment, watching the sunrise from the Roof of Africa. 

Uhuru Peak means Freedom Peak, such a fitting name. The best word to summarize my whole experience is liberating. About a week or so after I got home I physically ticked off “Climb Kilimanjaro” from my bucket list. (Yes I have an actual real life list. I’m a doctor, my life runs on lists.) Only then did I realize what I have achieved, and that in itself was liberating. I realized that the sky is my limit – I can actually achieve all the things on my bucket list, even the very ambitious ones like climb the highest mountain in Africa.

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